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Home My WebLink About01-1054 Register of Wills of Cumberland County, Pennsylvania Estate of FRANCES E. SIMMONS PETITION FOR GRANT OF LETTERS fAI-DI- 0/ 06~ No. also known as , Deceased Social Security No. PNC BANK, N.A. 198-36-2458 Peli1lonerlsl. who is/ar. 18 years of age or older. applyliesl for: (COMPLETE "A" OR "B" BELOW:) o A. Probate and Grant of Letters and aver that Petitioners are the executors named in the Last Will of the Decedent, dated and codicil(s) dated State r.levant circumstances. e.g.. renunciation. death of executor. etc. Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incompetent: JEI B. Grant of Letters of Administration Id.b.n.c.U.: pendent. lite; durante absentia; durante minoritat.1 Petitioner{s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: I Name Relationship Residence I JACK BAIR Nephew 2535 Cloverfield Lane Enola, PA 17025 BARBARA H. GAITHER Niece 954 Felton Road Red lion, PA 1 7356 WILLIAM BAIR Grand Nephew 3977 Brookridge Drive Mechanicsburg, PA 17055 THOMAS BAIR Grand Nephew 64 Barbara Lane Harrisburg, PA 1 7112 NANCY BAJR GRAHAM Grand Niece 1602 Attorney Court Herndon, Virginia 20170 (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal residence at Thornwald Home, 442 Walnut Bottom Road. Borouah of Carlisle. Cumberland County. Pennsylvania 17013 (list street, number and municipalityl Decedent, then ~ years of age, died August 31, 2001, at Thornwa)d Home. Carlisle, Cumberland County. Pennsylvania (location) Decedent at death owned property with estimated values as follows: (If domiciled in P A) All personal property ............................................................................ $ 900.000.00 (If not domiciled inPA) Personal property in Pennsylvania .......................................................... $ (If not domiciled in PAl Personal property in County.................................................................. $ Value of real estate in Pennsylvania ........................................ ........ ....... ................................................... $ Total.............................................................................. ..... .... ............ $ 900,000.00 Real Estate situated as follows: Wherefore, Petitioners respectfully request the probate of the last Will presented with this Petition and the grant of letters in the appropriate form to the undersigned: Signature Typed or printed name and residence PNC Bank, N .A. 4242 Carlisle Pike P.O. Box 38 Camp Hill. PA 17001-0308 ~ form RW-' Page 1 of 2 (Dauphin Countyl. Rev. 9/92 404122.1 11 -9, I - 1 \ Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland The Petitioner above-named swears and affirms that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner and that, as personal representative of the Decedent, Petitioner will well and truly administer the estate according to law. ~~.~_L_ . ~'l- u~ ~~~~_O~~ ~~- ~~ ~~~~ '.J,Li- ''2-I-~ No. :.:2/-01- OI05L( Deceased Estate of FRANCES E. SIMMONS Auaust 31, 2001 Date of Death: Social Security No: 198-36-2458 AND NOW, ~ (JlJ _ L (y , 2001, in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters 0 Testamentary X of Administration d.b.n.c.t.; pendente lite; durante abaentia; durante minorltate are hereby granted to PNC BANK, N.A. in the above estate and that the instrument(s) dated Nt A described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters.. .. .. .. .. ... . . . . . . . ... . . .. Short Certificate(s)...~... Renunciation................. . Affidavit ( )................. Extra Pages ( )............ Codicil......................... . JCP Fee........................ Inventory. ... . . . . . . . . . . . . . . . . . . . Other.. . . . . . . .. . . . . . . . .. . . . . . . . . . TOT AL... ....... ...... Form RW-' Page 2 of 2 (Dauphin Countyl- Rev. 9192 $ $ $ $ $ $ $ $ $ 4~o,o6 15.00 ~5.ob 5. (Jf) Attorney: Stanlev A. Smith 1.0. No: 33782 Address: Rhoads & Sinon LLP, PO Box 1146 1 South Market Sauare, Harrisbura, PA 17108-1146 Telephone: 717-233-5731 $ 525 -CO 10"~1)" RI'V qf~r; This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. No. ~(/ ,/?-Z ({;~~;~_c:.t"""/;;-";~/'-~'''' oJ> Local Registrar {j Fee for this certificate, $2.00 p 7621581 SEP 0 3 2001 Date :3 Rev. 2/87 COMMONWEALTH OF PENNSYLVANIA · OEPARTMENT OF HEALTH · VITAL RECOADS CERTIFICATE OF DEATH VIS- 8IRT~ (CAy alId Stale 01 Fcreogn COWWVl York, PA SWE'Il.E~ - SEX ~SOCIAL SECURITY NUMBER ~OAlE OF OERH ,Mc/IIIl. Oa~. '_, IIfatale a1~ -36 -2458 4Aug.31,2001 Pl..ACE OF DEAtH o-to 0I'tV ON - __ _'UCIlOnII on _ ... NAME OF DECEDENT cF"'. Modele. l., ,. NJIE. ClMI ~ Cumberland Co. DECEDENT"S USUAl <Give-oI- donedunnQ_ ~!fe.......'eit"'l n.. 1111. DECEDENTS WAIlMG AOORESS (SIr"'~, s..,lipCode\ 442 Walnut Bottan Rd. Carlisle, PA 17013 ,... RIntER"S NAME IF'" Modele. L.aII) 'L Reinicker Fite Herr INI'OIlIoWCrS NAME (T ypelPmlI Jack L. Bair METHOOOF own bane c.o. (I....!>+\ MAAITAL swus......... "--....... WIdlMM. wi~(SpeoIy) ,.. '7c.D ...___...... SUfMV1NQ SPOUSE ,1-.gn.e__1 93 ~ 0 l!M:lulpINnl 0 ~O :::.v, 0 s. COUNTY OfF OERH DECEDENT'S ACTUAl. ReSIDENCE --- on _ IICleI ... 2001 CUmberland '7.R ~-=='::::oI Carlisle MOTHEft.S NAME If... MocIcIe. MJ!l!!R SurllllNl 1 Emna. Jane. HeIIner 2535c~~;r~',s-~cn, PA 17025 PUCE OF 0lSP0IlTl0N. .......c..-v. ~ lOCRtON.~ lMMe. Z1pCocle Of~':Pect Hill Cemetery ork, PA 17404 :110. 1'& NAME AHDAODRESSOF Fi\ClU1Y .a ::1D4."L- . fue:a1lOIe.& cmn. Srv.324 H.rmel. ~,~~ LICENSE HUUlIER DArE SIGNED . MS/JCfSl)-L ~--~JL2MJ__ MS CASE REFERRED TO MEDICAl ElWoIlNEAICOAONEA? -)( .- ..0 lit. l~ PART I: 0IIw1ignillc8nl____~1O__.1lUl ! =- -= ................ .........._....... FMT 10 !\,)n ~ 1111. f.\ \ \'&1) ow 1O((lR AS A CONSEQUENCE OF): L ow 1O((lR AS A CONSEQUENCE OF): ow 10 ((lR AS A CONSEOUENCE OF): 'lMSAN AU1QPSV WERe AlJ10PSV FINDINGS PEAFOAUED? ~ PAIOAlO COMPl.ETlONOI CAUSE llERH1 MANNER OF DEATH DATE OF INJURV (MonIh. Day, 'lItat1 TIllE OF INJUAV INJURV Jfif INOAK? DESCAI8E HOW INJURY 0CCUflRE0:-- - .. 0 NII~ .. 0 No 0 ......... 15l Accmnl 0 SUicide 0 Hllmit:ide __ 0 NIID ........~ Could _ be ............ LOCAl'ION(S1r~~:_~~- -- --~~~~- 3Of. o ~ .;~OF~~T~\~ ~ ~ \lICENSE NUMBER TORE SIONED(MonIho Qrt. 'lItat1 o lu-.._..h"i:) ~ t'- ";2. ~ ti.~_.Jt,.. . ~'-Xt 6 L :Jo~ I oErwJ"~~=~:7"/U)~~~~~~ ~~~OO ,-- -- - --- - -- .~ . ~ - ... 2Ila. a. CUT..... ~~ oneI 'CUT1I'\'WIIG P1IYSICINI(Ph~~~~ de8lh __ phyllC........pronoo.nced_ atICI ~ Ilem 231 To.......ot"".__........ace..............ICauM(..--...-.. 0 o. 0... 0 0..... 0....0...... 0.0...................... .~1MC1NG AHDCUT....lNQNYSlQAN~tJQlI> ;>tonouoeong _ _..--toc..... 01 ....11>1 To'" .... ot lIlY............. .... ace........... _. _. _ pIKe. _ _ ..... ClIUM(al-...."".,.. aIa'N. . . 0 . . 0 . . . 0 . . . . 0 0 0 0 . 0 . . . 0 . 'UEDICAl EXAtoIlNEAICORONEA On the..... of eJUlllllNtIon andIoo '......'...Ilon. In my opinion, cte.Ih occuned..tIle 11m4I. dale. aIId place. and due to !he _..(.) aM :11.~ .. atated.. .. . . . . . . . 0 . 0 . . . . 0 . . . . .. .. .. 0 . . . . . . . . . . . . .. . .. . . . .. . . . . . . . . 0 . . 0 0 0 . . . 0 . . . .. .. . . .. .. . . . . . .. . . . .. . .. REGI",,'S S1GNAT~. N ~ /"C ~.4....!J-e;/',rT-~~ bl,/~,/y I on J Register of Wills of Cumberland County, Pennsylvania RENUNCIA TION Estate of FRANCES E. SIMMONS No.~ -01- 1054 also known as I Deceased The undersigned, THOMAS BAIR, Grand Nephew (Relationship) (Capacity) of the above Decedent, hereby renounces the right to administer the estate and respectfully requests that Letters of Administration be issued to PNC BANK, N.A. +~ fc . Witness my hand this ~ day of Dc 0 he r I 2001. ~'t:~ 64 Barbara Lane Harrisburg, PA 17112 Sworn to or affirme~nd subscribed before me this S day of ocr ,2001. ~ My Commission Expires: (Signature and .eal of Notary or other official NOTE: Renunciations executed outside the Office of Register of Wills are required in some counties to be notarized. qualified to admini.t.r oaths. Show date of expiration of Notary', commlssion.l NOTARIAL SEAL LLOYD P. SCHROEDER, NotarY Public Harrisburg. Dauphin County. PA My CommIssion Expires May 02. 2005 402928.5 Register of Wills of Cumberland County, Pennsylvania RENUNCIA TION Estate of FRANCES E. SIMMONS No. <91-01-'D.5~ also known as , Deceased The undersigned, NANCY BAIR GRAHAM. Grand Niece (Relationship) (Capacity) of the above Decedent, hereby renounces the right to administer the estate and respectfully requests that Witness my hand this 9 rk PNC BANK. N.A. day of Nil toI-L ""'" 19 ~ ,2001. Letters of Administration be issued to ~ 2253 Christy Place Herndon, VA 22070 Sworn to or affirmed and subscribed before me this q- +- k..- day of A1d,,~~b~ .2001. L~c 1?~~4/~ My Commission Expires: My Comr~ission Expires June 30, 2003 NOTE: Renunciations executed outside the Office of Register of Wills are required in some counties to be notarized. (Signature and &ea' of Notarv or other official qualified to administer oaths. Show date of expiratiOn of Notary's commission.) 402928.3 Register of Wills of Cumberland County, Pennsylvania RENUNCIA TION Estate of FRANCES E. SIMMONS No. ~J-OCJo51 also known as , Deceased The undersigned, JACK BAIA. Nephew (Relationship) (Capacity) of the above Decedent, hereby renounces the right to administer the estate and respectfully requests that letters of Administration be issued to PNC BANK. N.A. Witness my hand this 7(1, day of ~ ,2001. ~~a~' ;~C loverfield lane Enola, PA 17025 Sworn to or affirmed and subscribed before me this day of ,2001. Notary Public My Commission Expires: (Signature and seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's commission.) NOTE: Renunciations executed outside the Office of Register of Wills are required in some counties to be notarized. 402928.4 Register of Wills of Cumberland County, Pennsylvania Estate of FRANCES E. SIMMONS RENUNCIA TION No.~-Ol-DI os~ also known as , Deceased The undersigned, BARBARA H. GAITHER. Niece (Relationship) (Capacity) of the above Decedent, hereby renounces the right to administer the estate and respectfully requests that letters of Administration be issued to PNC BANK. N .A. Witness my hand this In/;'''...t:i day of () U ~ , 2001 . ~#'.~ BARBARA H. GAITHER 954 Felton Road Red lion, PA 17356-9311 Sworn to or affirmed and subscribed before me this day of .2001. Notary Public My Commission Expires: (SillMture and seal of Notary or other official qualified to administer oatha. Show date of expiration of Notary's commission.) NOTE: Renunciations executed outside the Office of Register of Wills are required in some counties to be notarized. 402928.1 Register of Wills of Cumberland County, Pennsylvania RENUNCIA TION FRANCES E. SIMMONS No. ~I-OI- LOS4- Estate of also known as , Deceased The undersigned, WILLIAM BAIR. Grand Neohew (Relationship) (Capacity) of the above Decedent, hereby renounces the right to administer the estate and respectfully requests that Letters of Administration be issued to PNC BANK, N.A. Witness my hand this if<a- day of () ~~ ,2001. !J.!A~ WILLIAM BAIR 3977 Brookridge Drive Mechanicsburg, PA .17055 Sworn to or affirmed and subscribed before me this -o-'G-. day of _~~~ .2001. Notary Public My Commission Expires: Notarial Seal Shannon Cramer, Notary Public Sliver Spring Twp.. Cumberland County My Commission Expires Oct. 11, 2004 Member, pennsyMmla Association 01 Notaries (Signature and seal of Notary or other official NOTE: Renunciations executed outside the Office of Register of Wills are required in some counties to be notarized. qualified to administer oaths. Show date of expiration of Notary's commission.! 402928.2 '0 Stanley A. Smith, Esquire Attorney ID No. 33782 Rhoads & Sinon LLP One South Market Square P. O. Box 1146 Harrisburg, PA 17108-1146 (717) 233-5731 Attorneys for Petitioner INRE: ESTATE OF FRANCES E. SIMMONS, Deceased IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION : NO. 2001-01054 CERTIFICATION OF NOTICE I, Stanley A. Smith, Esquire, attorney for PNC Bank, N.A., Administrator of the above estate, does hereby certify that on January 31, 2003, I caused notice of the filing of the Administrator's First and Final Account to be served on the following, by certified mail, return receipt requested: Ms. Barbara H. Gaither 954 Felton Road Red Lion, P A 17356-9311 Mr. Jack L. Bair 2535 Cloverfield Lane Enola, P A 17025 Mr. William H. Bair 3977 Brookridge Drive Mechanicsburg, P A 17050 Mr. Thomas R. Bair 64 Barbara Lane Harrisburg, P A 17112 Ms. Nancy Bair Graham 1602 Attorney Court Herndon, VA 20170 Date: ~b 3J Zoo3 . RHOADS~ . BY:~ Stanley A. Smith I.D. 33782 One South Market Square PO Box 1146 Harrisburg, P A 17108-1146 (717) 233-5731 459480.1 ......- J:::- CERTIFICATE OF NOTICE UNDER RULE 5.6(a) Name of Decedent: FRANCES E. SIMMONS Date of Death: AUGUST 31, 2001 621 Will No. ~-2001-M;iiI:- 105Y- To the Register: Adm. No. I certify that notice of estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries and intestate heirs of the above- captioned estate on NOVEMBER 27, 2001. Name Address Barbara H Gaither 954 Felton Road Red Lion, 17356-9311 Jack Bair 2535 Cloverfield Lane Enola, P A 17025 William Bair 3977 Brookridge Drive Mechanicsburg, Pa 17055 Thomas Bair 64 Barbara Lane Harrisburg, P A 17112 Nancy Bair Graham 1602 Attorney Court Herndon, VA 20170 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: @: ~ 2001 ~=~:::Il:jl/jiJk Address: RHOADS & SINON LLP P.O. Box 1146 Harrisburg, PA 17108 Telephone: (717 ) 233-5731 (V) .;~ :-:'L..,.., ,.~~s\ 0.... 0\ - :) Capacity: xx Counsel for Personal Representative {j) ~J ~:~:(~ l;=3 .. ~~~ on> (DO: 0: c..J CJ .~~~ '-. :. w .. .0 .-C s:: a>= Gu - p 412493.1 IN RE: ESTATE OF FRANCES E. SIMMONS, DECEASED : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA : ORPHANS' COURT DIVISION : NO. 2001 - 01054 RECEIPT. RELEASE AND REFUNDING AGREEMENT WITNESSETH: WHEREAS, Frances E. Simmons (the "Decedent"), died August 31,2001, intestate, leaving no original will which could be offered for probate; WHEREAS, the Decedent's husband, Lester Simmons, died before her and Decedent had no issue; WHEREAS, Decedent's next of kin were her sisters, Loretta B. Hess and Ann B. Bair. Loretta B. Hess died April 12, 1991 and Ann B. Bair died December of 1991, both predeceasing Decedent; WHEREAS, Loretta B. Hess had one child, Barbara Hess Gaither, who survived the Decedent; WHEREAS, Ann B. Bair had two children, Jack Bair, who survived Decedent, and Herbert Bair who died before Decedent but was survived by three children: William H. Bair, Thomas R. Bair and Nancy Bair Graham; WHEREAS, PNC Bank, N.A. was appointed administrator of the estate of Frances E. Simmons by the Register of Wills of Cumberland County, Pennsylvania; and WHEREAS, the Court has confirmed the Administrator's First and Final Account and ordered distribution of the remaining assets of the Estate. 429987.1 NOW THEREFORE, the undersigned, jointly and severally, for themselves, their heirs, administrators, and assigns: 1. Do hereby acknowledge that all of the foregoing recitals are true and correct to the best of the undersigned's knowledge, information and belief. 2. Do hereby acknowledge receipt from the Administrator of the amount set forth below adjacent to his or her name in full and complete satisfaction of his or her shares of the Estate: Name Percentage Amount Barbara H. Gaither 500/0 $362,461.71 Jack L. Bair 250/0 $181,230.86 William H. Bair 8.3% $ 60,410.29 Thomas R. Bair 8.30/0 $ 60,410.29 Nancy Bair Graham 8.30/0 $ 60,410.29 3. Do hereby absolutely and irrevocably release, remise, quitclaim and forever discharge the said Administrator, its heirs, successors, assigns, employees and agents, of and from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever for or by reason of the distributions provided for herein and any other matter whatsoever. 4. Do hereby agree that if, at any time in the future, the said Administrator recei ves any demand or claim for any amount claimed to be due and owing from it, as Administrator, and it approves said demand or claim, they shall, at the request of the said Administrator, pay to the Administrator the amount of any such demand or cla~m, or if it has been paid by the said - 2 - . . Administrator, then reimburse it for the amount paid by it, provided that the amount of such requested payment or reimbursement by any Beneficiary shall not exceed the total of the assets paid or distributed by said Administrator to the Beneficiary as set forth herein. 5. Hereby agree that this Receipt, Release and Refunding Agreement, is intended to be and shall be legally binding upon the undersigned, their heirs, administrators and assigns. 6. This Agreement may be executed in several counterparts, each of which shall be an original and all of which shall constitute but one and the same instrument. IN WITNESS WHEREOF, the undersigned have hereunto set their hands and seals this f ~ 'Mday of fi] 0 rch . 2003. Witness: !f;ZlJ1dfl 9' /Jcgo 11/~1;~ ~4d'k/ Barbara Hess Gaither Jack L. Bair William H. Bair Thomas R. Bair Nancy Bair Graham - 3 - Administrator, then reimburse it for the amount paid by it, provided that the amount of such requested payment or reimbursement by any Beneficiary shall not exceed the total of the assets paid or distributed by said Administrator to the Beneficiary as set forth herein. 5. Hereby agree that this Receipt, Release and Refunding Agreement, is intended to be and shall be legally binding upon the undersigned, their heirs, administrators and assigns. 6. This Agreement may be executed in several counterparts, each of which shall be an original and all of which shall constitute but one and the same instrument. IN WITNESS WHEREOF, the undersigned have hereunto set their hands and seals this / () day of /{ IUe( . 2003. Witness: Barbara Hess Gaither ~~ .' /J ~...~/) ~'.' fl' .' \;,./ - ,-, .....-, I ~/.. <:>~ J;J{ ~~ v' William H. Bair Thomas R. Bair Nancy Bair Graham - 3 - Administrator, then reimburse it for the amount paid by it, provided that the amount of such requested payment or reimbursement by any Beneficiary shall not exceed the total of the assets paid or distributed by said Administrator to the Beneficiary as set forth herein. 5. Hereby agree that this Receipt, Release and Refunding Agreement, is intended to be and shall be legally binding upon the undersigned, their heirs, administrators and assigns. 6. This Agreement may be executed in several counterparts, each of which shall be an original and all of which shall constitute but one and the same instrument. IN WITNESS WHEREOF, the undersigned have hereunto set their hands and seals this ID day of ;ltJlrrit . 2003. Witness: Barbara Hess Gaither Thomas R. Bair Nancy Bair Graham - 3 - Administrator, then reimburse it for the amount paid by it, provided that the amount of such requested payment or reimbursement by any Beneficiary shall not exceed the total of the assets paid or distributed by said Administrator to the Beneficiary as set forth herein. 5. Hereby agree that this Receipt, Release and Refunding Agreement, is intended to be and shall be legally binding upon the undersigned, their heirs, administrators and assigns. 6. This Agreement may be executed in several counterparts, each of which shall be an original and all of which shall constitute but one and the same instrument. IN WITNESS WHEREOF, the undersigned have hereunto set their hands and seals this &dayof f/l&t-V'<: 0 .2003. Witness: Barbara Hess Gaither Jack L. Bair ~i~D~ ~~i'~~,~ William H. Bair ~~r~ 'Fftomas R. Bair Nancy Bair Graham - 3 - Administrator, then reimburse it for the amount paid by it, provided that the amount of such requested payment or reimbursement by any Beneficiary shall not exceed the total of the assets paid or distributed by said Administrator to the Beneficiary as set forth herein. 5. Hereby agree that this Receipt, Release and Refunding Agreement, is intended to be and shall be legally binding upon the undersigned, their heirs, administrators and assigns. 6. This Agreement may be executed in several counterparts, each of which shall be an original and all of which shall constitute but one and the same instrument. IN WITNESS WHEREOF, the undersigned have hereunto set their hands and seals this /9 day of ~. 2003. Witness: Barbara Hess Gaither Jack L. Bair William H. Bair ~~Ji~ d~ Thomas R. Bair ~~ - 3 - COMMONWEAL TH OF PENNSYLVANIA ) ) SS COUNTY OF YOfl..K ) On this, the I d M day of march . 2003, before me, a Notary Public, the undersigned officer, personally appeared BARBARA HESS GAITHER, an adult individual, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purposes therein contained. I' IlAm&~J ~''''"' ~~~~ If 1.1"",", .. 'w'~,..~. r\t~~'i~~tl,t rT-.~;t~J~~ 4~"t~~1;;!~;~~~~:1 IN WITNESS WHEREOF, I hereunto set my hand and official seal. t!if~9'Jy2 o Public . My Commission Expires: (SEAL) COMMONWEAL TH OF PENNSYL VANIA ) .,./ . . " ) SS COUNTY OF C L/,/?/ b"//:;.r;1c~ ) On this, the / /r-day of /;12'" c L---, I Public, the undersigned officer, personally appeared JACK L. BAIR, an adult individual, known to me . 2003, before me, a Notary (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and offi ial seal. j---" ,'6T,\;::0:-~~'~'" ' " \ DE'M'\~L\.c~ni::~;i~\~~' E"J"S5 No\}, 22, ;,.~4 . i , . y on 110 -'~\v\ . ".t "'_I!&[IJ~~' , ~:1~.'t"~""""i't'~.""'~.'\;-'llt::;i1h";.f~."j;i7-""'~ COMMONWEAL TH OF PENNSYL VANIA ) ) SS COUNTY OFC~ber\<l.Y"C\ ) On this, the ~ day of JY'o Yl" h . 2003, before me, a Notary Public, the undersigned officer, personally appeared WILLIAM H. BAIR, an adult individual, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Notarial Seal S '} Am~ Jo Schaeffer. Notary Public Mere prin~ ?WP.. e~mberland Coumy y omnusslon ExpIres Jan. 6. 2007 Met'nber. PElnnSytvan;a AssoclatiOOof COMMONWEAL TH OF PENNSYLVANIA COUNTY ~...,,:, On this, the ~r\.t> day oM~~ ) ) SS ) . 2003, before me, a Notary Public, the undersigned officer, personally appeared THOMAS R. BAIR, an adult individual, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I her NOTARIAL SI!AL Carrie Jean Singer, Notary Pubfic Lower Paxton Twp. Dauphin County My Commission Expires September 7, 2006 '1,(. . ci;t V I V'~ COMMONWEAL TH OF r[N~ MIA COUNTY OF ~ ) ) SS ) On this, the /1 day of ~ . 2003, before me, a Notary Public. the undersigned officer, personally appeared NANCY BAIR GRAHAM, an adult individual, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purposes therein contained. IN WIlNESS WHEREOF, I hereunto S(J:&ffiCial seal. K~'1 Notary Publici My Commission Expires: . My Commi . Ex' J I (SEAL) ~ sSlon pIres uy31,2006 '" o PNCBAN< COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PA ORPHANS' COURT DIVISION NO._ ESTATE OF FRANCES E SIMMONS DECEASED LATE OF THE BOROUGH OF CARLISLE FIRST AND FINAL ACCOUNT OF PNC BANK, NATIONAL ASSOCIATION ADMINISTRATOR DATE OF DEATH AUGUST 31 2001 WILL NO. 21-01-1054 LETTERS GRANTED NOVEMBER 16 2001 FIRST COMPLETE ADVERTISEMENT OF GRANT OF LETTERS DECEMBER 7 ZOOl ACCOUNTING NOVEMBER 16 2001 TO JANUARY 21 2003 PURPOSE OF ACCOUNT: THE ADMINISTRATOR OFFERS THIS ACCOUNT TO ACQUAINT INTERESTED PARTIES WITH THE TRANSACTIONS THAT HAVE OCCURRED DURING ITS ADMINISTRATION OF THE ESTATE. IT IS IMPORTANT THAT THE ACCOUNT BE CAREFULLY EXAMINED. REQUESTS FOR ADDITIONAL INFORMATION OR QUESTIONS OR OBJECTIONS CAN BE DISCUSSED WITH: PNC BANK, NATIONAL ASSOCIATION C/O LINDA J LUNDBERG ASSISTANT VICE PRESIDENT POBOX 308 CAMP HILL PA 17001-0308 TELEPHONE (717) 730-2265 STANLEY A SMITH ESQUIRE RHOADS & SINON LLP ONE S MARKET SQUARE POBOX 1146 HARRISBURG PA 17108-1146 TELEPHONE (717) 231-6628 - 1 - TRSNOl ClOIOZI FRANCES SIMMONS PRINCIPAL RECEIPTS NET GAIN/LOSS ON CONVERSIONS ADJUSTED BALANCE lESS DISBURSEMENTS DEBTS OF DECEDENT FUNERAL EXPENSES ADMINISTRATIVE EXPENSES FEDERAL AND STATE TAXES FEES AND COMMISSIONS FAMILY EXEMPTION TOTAL PRINCIPAL DISBURSEMENTS BALANCE BEFORE DISTRIBUTIONS DISTRIBUTIONS TO BENEFICIARIES PRINCIPAL BALANCE ON HAND INVESTMENTS MADE CHANGES IN INVESTMENT HOLDINGS INCOME RECEIPTS LESS DISBURSEMENTS BALANCE BEFORE DISTRIBUTIONS DISTRIBUTIONS TO BENEFICIARIES INCOME BALANCE ON HAND COMBINED BALANCES REMAINING o PNCBAN< 770437 SUMMARY AND INDEX ~ 3 - 3 962,055.09 4 - 5 6,688.12 968,743.21 6 - 6 6 - 6 6 - 7 7 - 7 7 - 7 6 - 7 3,403.38- 5,802.00- 1,412.24- 192,349.00- 43,641.00- .00 246,601.62- 722,135.59 .00 8 - 8 722,135.59 9 - 9 10 - 11 23,344.92 12 - 12 3,743.12- 19,601.80 13 - 13 16,813.95- 14 - 14 2,787.85 124,923.44 - 2 - TRSNOl UOIOZJ PNC ADVISORS o PNCBAN< FRANCES SIMMONS 770437 GAINS AND LOSSES ON SALES AND OTHER DISPOSITIONS 2Alt! .IJ}ll 11/20/01 27,462.308 UTS BLACKROCK FUNDS GNMA PORTFOLIO FUND 67 INSTITUTIONAL CLASS CAPITAL GAIN REINVESTMENT PROCEEDS: 283,147.37 ACQUISITION VALUE: 279.532.74 570.955 UTS BLACKROCK FUNDS GNMA PORTFOLIO FUND 67 INSTITUTIONAL CLASS 3,614.63 11/23/01 12/14/01 PROCEEDS: 5,738.10 ACQUISITION VALUE: 5.811.62 3,000 PAR USA SAVINGS BONDS SERIES HH DTD 05/01/1984 DUE 08/31/01 73.52- 2/07/02 PROCEEDS: ACQUISITION VALUE: RINGS PROCEEDS: 250.00 ACQUISITION VALUE: 252.00 TOTAL GAINS AND LOSSES LESS LOSS NET GAIN 3,000.00 3.000.00 .00 9,415.49 2.727.37- 6,688.12 2.00- 2,727.37- ---------- ---------- TRSNOZ II O/OZ) - 5 - FRANCES SIMMONS 11/16/01 11/16/01 11/16/01 11/16/01 11/16/01 11/16/01 11/16/01 11/26/01 12/04/01 5/22/02 1/21/03 FRANCES SIMMONS 1/21/03 11/26/01 5/21/02 5/22/02 11/20/02 1/21/03 1/21/03 FRANCES SIMMONS PNC ADVISORS DISBURSEMENTS OF PRINCIPAL DEBTS OF DECEDENT PHARMERICA PRESCRIPTION SERVICE PENNA DEPARTMENT OF REVENUE QUARTERLV 2001 ESTIMATED INDIVIDUAL INCOME TAX PNC BANK, NATIONAL ASSOCIATION CHECKING ACCOUNT .5140104218 RECLAIMED SOCIAL SECURITY CHECK PNC BANK, NATIONAL ASSOCIATION TRUSTEES COMPENSATION TOTAL DEBTS OF DECEDENT FUNERAL EXPENSES MUSSELMAN FUNERAL HOME FUNERAL SERVICES PROSPECT HILL CEMETERY GRAVE MARKER INSCRIPTION 495.00 90.00 MR JACK L BAIR REIMBURSEMENT FOR GRAVE OPENING SERVICES 655.00 75.00 TOTAL FUNERAL EXPENSES ADMINISTRATIVE EXPENSES STANLEY A SMITH ESQUIRE REIMBURSEMENT FOR PROBATE COST ROSE MARIES ANTIQUES APPRAISAL FEE RE PERSONAL PROPERTY REGISTER OF WILLS FEE FOR FILING PENNA INHERITANCE TAX 15.00 INVENTORV 16.00 RHOADS & SINON LLP REIMBURSEMENT FOR LEGAL ADVERTISING COPIES ETC - 6 - PNC ADV~SORS DISBURSEMENTS OF PRINCIPAL REGISTER OF WILLS ESTIMATED COST FOR FILING ACCOUNT TOTAL ADMINISTRATIVE EXPENSES FEDERAL AND STATE TAXES REGISTER OF WILLS PENNA INHERITANCE TAX 128,000.00 ON ACCOUNT LESS 5X DISCOUNT 6,400.00 INTERNAL REVENUE SERVICE FEDERAL ESTATE TAX REGISTER OF WILLS BALANCE PENNA INHERITANCE TAX INTERNAL REVENUE SERVICE FIDUCIARV INCOME TAX ON CAPITAL GAINS FOR YEAR ENED 7/1/02 TOTAL FEDERAL AND STATE TAXES FEES AND COMMISSIONS RHOADS & SINON LLP COUNSEL FEE PNC BANK, NATIONAL ASSOCIATION ADMINISTRATORS COMPENSATION TOTAL FEES AND COMMISSIONS TOTAL PRINCIPAL DISBURSEMENTS - 7 - PNC ADVISORS PRINCIPAL BALANCE ON HAND INVESTED CASH TOTAL PRINCIPAL - 8 - o PNCBAN< o PNCBAN< 710431 218.46- 310.00- 855.00- 2,019.92- 3,403.38- 4,487.00- 585.00- 730.00- 5,802.00- 525.00- 20.00- 31.00- 336.24- TRSN02110102) 770431 500.00- 1,412.24- 121,600.00- 62,043.00- 8,524.00- 182.00- 192,349.00- 18,000.00- 25,641.00- o PNCBAN< VALUE 1/21/03 722,135.59 722,135.59 43,641.00- 246,607.62- ------------ ------------ TRSN02110102) 77043 ACQUISITIO; VALU: 722,135.5 722,135.5 ------------ ----------- ------------ ----------- TRSN02 110102) PNC ADVISORS o PNCBAN< FRANCES SIMMONS 11/20/01 PRINCIPAL INFORMATION SCHEDULES - INVESTMENTS MADE 570.955 UTS BLACKROCK FUNDS GNMA PORTFOLIO FUND 67 INSTITUTIONAL CLASS INCOME REINVESTMENT - 9 - 770431 5,778.06 TRSN02 C1 0102) PNC ADVISORS FRANCES SIMMONS RECEIPTS OF INCOME INTEREST PNC BANK NATIONAL ASSOCIATION CHECKING ACCOUNT 15140104218 CLOSING INTEREST USA SAVINGS BONDS SERIES HH DUE 05/01/04 11/06/01 60.00 DIVIDEND BELLSOUTH CORP COMMON 11/01/01 11/16/01 76.00 SBC COMMUNICATIONS INC COMMON 11/01/01 184.50 VERIZON COMMUNICATIONS INC COMMON 11/01/01 194.81 OTHER INCOME BLACKROCK FUNDS INDEX EQUITY PORTFOLIO FUND 45 INSTITUTIONAL CLASS 9/27/01 132.89 BLACKROCK FUNDS INTER GOVERNMENT PORTFOLIO FUND 80 INSTITUTIONAL CLASS 10/01/01 11/01/01 12/03/01 12/04/01 BLACKROCK FUNDS MANAGED PORTFOLIO FUND 13 INSTITUTIONAL CLASS 10/01/01 11/01/01 12/03/01 12/04/01 BlACKROCK FUNDS GNMA PORTFOLIO FUND 67 INSTITUTIONAL CLASS 10/01/01 11/01/01 12/03/01 12/04/01 BLACKROCK US TREASURY MM INSTITUTIONAL CLASS FD .02 10/01/01 11/01/01 12/03/01 - 10 - 973.07 976.22 130.16 488.11 INCOME 1,192.99 1,196.85 159.58 598.42 1,297.20 1,290.73 189.73 697.96 45.33 45.08 4.87 o PNCBAN< 770437 37.97 60.00 76.00 184.50 194.81 132.89 2,567.56 3,147.84 3,475.62 TRSN02ClO/OZ) PNC ADVISORS FRANCES SIMMONS RECEIPTS OF INCOME CONTINUED: BlACKROCK US TREASURY MM 12/03/01 12/04/01 1102102 1/02/02 2/01/02 2/01/02 3/01/02 3/01/02 4/01/02 4/01/02 5/01/02 5/01/02 6/03/02 6/03/02 7/01/02 7/01/02 8/01/02 8/01/02 9/03/02 9/03/02 10/01/02 10/01/02 11/01/02 11/01/02 12/02/02 12/02/02 1102103 1/02/03 TOTAL INCOME 458.93 25.85 14.45 1,197.69 15.29 1,114.20 15.42 1,032.66 18.31 1,135.38 19.60 1,120.56 21.61 1,119.90 21.33 978.37 2.54 947.71 2.23 940.40 3.10 901.23 4.16 896.55 3.13 705.11 1.82 654.92 - 11 - o PNCBAN< 770437 13,467.73 23,344.92 ------------ ------------ TRSN02 (lOl02) DISBURSEMENTS OF INCOME PENNA DEPARTMENT OF REVENUE FIDUCIARY INCOME TAX FOR YEAR ENDED 7/31/02 INTERNAL REVENUE SERVICE FIDUCIARY INCOME TAX FOR YEAR ENDED 7/31/02 PNC BANK NATIONAL ASSOCIATION INCOME COMPENSATION 12/10/01 1/10/02 2/08/02 3/08/02 4/10/02 5/10/02 6/10/02 7/10/02 8/09/02 9/10/02 10/10/02 11/08/02 12/10/02 1/10/03 FRANCES SIMMONS 11/20/02 11/20/02 PNC ADVISORS TOTAL INCOME DISBURSEMENTS - 12 - 58.87- 12.13- 61.11- 62.88- 69.22- 68.41- 68.49- 59.98- 51.02- 56.56- 54.26- 54.04- 42.49- 39.40- o PNCBAN< 110431 505.00 2,406.00 832.12- 3,143.12- ---------- ---------- TRSN0211 OIOZJ FRANCES SIMMONS PNC ADVISORS DISTRIBUTIONS OF INCOME TO BENEFICIARIES THOMAS R BAIR 7/02/02 CASH DISTRIBUTED NANCV BAIR GRAHAM 7/02/02 CASH DISTRIBUTED BARBARA H GAITHER 7/02/02 CASH DISTRIBUTED JACK L lAIR 7/02/02 CASH DISTRIBUTED WILLIAM H lAIR 7/02/02 CASH DISTRIBUTED TOTAL INCOME DISTRIBUTIONS - 13 - o PNCBAN< 1,401.16- 1,401.16- 8,406.98- 4,203.49- 1,401.16- 770437 1,401.16' 1,401.16' 8,406.98- 4,203.49 1,401.16 16,813.95- ---------- ---------- TRSNOZ C 'O'OZ) PNC ADVISORS FRANCES SIMMONS BALANCE OF INCOME ON HAND INVESTED CASH TOTAL INCOME - 14 - o PNCBAN< VALUE 1/21/03 2,787.85 2,787.85 770437 ACQUISITION ~ 2,787.85 2,787.85 ------------ ------------ ------------ ------------ TRSN02 (101021 PNC ADVISORS o PNCBAN< 770437 ESTATE OF FRANCES E SIMMONS DECEASED (DIED 08/31/01) PNC BANK, NATIONAL ASSOCIATION BY~~ d- ADMINISTRATOR TRSN02110102J - 15 - PNC ADVISORS o PNCBAN< COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS LINDA J LUNDBERG BEING DULY AFFIRMED ACCORDING TO LAW DEPOSES AND SAYS THAT SHE IS AN ASSISTANT VICE PRESIDENT OF PNC BANK, NATIONAL ASSOCIATION, THE ACCOUNTANT NAMED IN THE FOREGOING ACCOUNT AND THAT THE SAID ACCOUNT IS JUST AND TRUE TO THE BEST OF HER KNOWLEDGE AND BELIEF AND THE GRANT OF LETTERS AND THE FIRST COMPLETE ADVERTISEMENT THEREOF OCCURRED MORE THAN FOUR MONTHS BEFORE FILING OF THE ACCOUNT AND THE DECEDENT WAS NOT ADJUDICATED INCOMPETENT AFFIRMED AND SUBSCRIBED TO 011#1 DAY 20C.3 :~~ -- : ~ OF I HEREBY CERTIFY THAT I AM NOT A DIRECTOR OR OFFICER OF PNC BANK, NATIONAL ASSOCIATION ~~fm~ Notarial Seal Sherry M. Baney, Notary Public Hampden Twp., Cumberland County My COmmission Expires June 25. 2005 Member, Pennsylvania Association of Notaries TRSN02110102) - 16 - . '.... " PNCBAN] ESTATE OF FRANCES E SIMMONS DECEASED (DIED 08/31/01) LATE OF THE BOROUGH OF CARLISLE CUMBERLAND COUNTY PA WILL NO 21-01-1054 INVENTORY COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND LINDA J LUNDBERG ASSISTANT VICE PRESIDENT OF PNC lANK, NATIONAL ASSOCIATION THE ADMINISTRATOR OF THE ESTATE OF FRANCES E SIMMONS DECEASED HAVING BEEN DULV AFFIRMED ACCORDING TO LAW DID DEPOSE AND SAY THAT THE ITEMS APPEARING IN THE FOLLOWING INVENTORV ARE PERSONAL ASSETS WHEREVER SITUATE AND REAL ESTATE IF ANY IN THE COMMONWEALTH OF PENNSYLVANIA OF SAID DECEDENT THAT THE VALUATION PLACED OPPOSITE EACH ITEM OF SAID INVENTORY REPRESENTS ITS FAIR VALUE AS OF THE DATE OF THE DECEDENT'S DEATH AND THAT THE DECEDENT OWNED NO REAL ESTATE OUTSIDE THE COMMONWEALTH OF PENNSVLVANIA EXCEPT THAT WHICH APPEARS IN A MEMORANDUM AT THE END OF THIS INVENTORY AFFIRMED AND SUBSCRIBED BEFORE ME .~ TH~:..~~ . .. DAY OF ~ 2D~1 /1~;;~;~~~';:):'~"':: . ' \, ),,~"'-., I :I' .- .... ,'~':;/-'-:? - ~ ~ .:';:-~l ~. ':-'.,. -"~ : - ~~~ ~ :C;<:lUU~J ~#.' 9U: Uil vZ I ~!I1 20 .\ 11;~ . NOTARIAL SEAL DENISE C. SUllENBERGER, Notary Pubic Hampden Twp, , CumberlandCotinty . My Commission Expires Nov. 22, 2004 - 1 ~ :; '''-'~j '..:-~ 8;)tf TR8N01 lUll.. . PRIVATE BANK PNCBANK FRANCES SIMMONS 770437 MISCEllANEOUS RINGS PNC BANK, NATIONAL ASSOCIATION TRUSTEE UNDER THE AGREEMENT OF TRUST OF FRANCES E SIMMONS DATED 8/7/86 ASSETS HELD AS OF 8/31/01 (DATE OF DEATH) lIlHD.S. 3,000 PAR USA SAVINGS BONDS SERIES HH DTD 05/01/1984 DUE 08/31/01 ; 100.0000 COMMON STOCKS 400 SHS BELLSOUTH CORP COMMON ; 37.7000 150 SHS FPl GROUP INC COMMON ; 54.7500 DIVIDEND PAYABLE 9/17/01 200 SHS QWEST COMMUNICATIONS COMMON ; 21.1900 720 SHS SBC COMMUNICATIONS INC COMMON ; 40.9300 506 SHS VERIZON COMMUNICATIONS INC COMMON ; 49.9000 f:IlHD} 2,953.119 UTS BlACKROCK FUNDS INDEX EQUITY PORTFOLIO FUND 45 INSTITUTIONAL CLASS ; 21.8500 20,552.059 UTS BLACKROCK FUNDS INTER GOVERNMENT PORTFOLIO FUND 80 INSTITUTIONAL CLASS ; 10.3900 INCOME TO 8/31/01 24,425.512 UTS BLACKROCK FUNDS MANAGED INCOME PORTFOLIO FUND 13 INSTITUTIONAL CLASS ; 10.5500 INCOME TO 8/31/01 252.00 3,000.00 15,080.00 8,212.50 84.00 4,238.00 29,469.60 25,249.40 64,525.65 213,535.89 976.22 257,689.15 1,196.85 TRSN02C10185) - 2 - ---------------~---------------------- - # PRIVATE BANK PNClBANK FRANCES SIMMONS CONTINUED: FUNDS 27,462.308 UTS BLACKROCK FUNDS GNMA PORTFOLIO FUND 67 INSTITUTIONAL CLASS a 10.1800 INCOME TO 8/31/01 ~ PRINCIPAL CASH INCOME TO 8/31/01 279,566.30 1,400.58 16,266.13 54.29 ~ CAREFIRST BLUECROSS BLUESHIELD INSURANCE BENEFITS CASH FOUND IN ROOM PNC BANK NATIONAL ASSOCIATION CHECKING ACCOUNT 15140104218 DATE OF DEATH BALANCE 36,600.89 INTEREST TO 8/31/01 10.58 UNITED CHURCH OF CHRIST HOMES BALANCE IN PERSONAL RESIDENT TRUST FUND AARP REFUND DUE TO CANCELLATION OF MEMBERSHIP ADP COBRA SERVICES REFUND ON UNUSED PREMIUM PENNA DEPARTMENT OF REVENUE REFUND 2001 INDIVIDUAL INCOME TAX TOTAL INVENTORY - 3 - 770437 920,544.56 8.58 9.00 36,611.47 249.72 30.00 4,124.76 225.00 962,055.09 ============ TASN02110185) INRE: ESTATE OF FRANCES E. SIMMONS, Deceased : IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA : ORPHANS' COURT DIVISION : NO. 2001-01054 STATEMENT OF PROPOSED DISTRIBUTION OF PNC BANK, NATIONAL ASSOCIATION, ADMINISTRATOR OF THE ESTATE OF FRANCES E. SIMMONS WHEREAS, Frances E. Simmons (the "Decedent"), died August 31, 2001, intestate, leaving no original will which could be offered for probate; WHEREAS, the Decedent's husband, Lester Simmons, died before her and Decedent had no issue; WHEREAS, Decedent's next of kin were her sisters, Loretta B. Hess and Ann B. Bair. Loretta B. Hess died April 12, 1991 and Ann B. Bair died December of 1991, both predeceasing Decedent; WHEREAS, Loretta B. Hess had one child, Barbara H. Gaither, who survived the Decedent; WHEREAS, Ann B. Bair had two children, Jack L. Bair, who survived Decedent, and Herbert Bair who died before Decedent but was survived by three children: William H. Bair, Thomas R. Bair and Nancy B. Graham; WHEREAS, the Decedent's intestate heirs are therefore as follows: Barbara H. Gaither Jack L. Bair William H. Bair Thomas R. Bair Nancy B. Graham 50% 25% 8.3% 8.3% 8.3% 459461.1 WHEREAS, PNC Bank, National Association was appointed administrator of the estate of Frances E. Simmons by the Register of Wills of Cumberland County, Pennsylvania; and WHEREAS, notice of such issuance of letters of administration was duly advertised in the Patriot News on December 4, 11 and 18, 2001, and the Cumberland Law Journal on December 7, 14 and 21, 2001; WHEREAS, all Federal Estate Tax and Pennsylvania Inheritance Taxes have been paid and all claims against the Estate have been paid or adequately provided for; and WHEREAS, the balance for distribution as shown on the First and Final Account ofPNC Bank, National Association, is $724,923.44, comprised of principal cash of$722,135.59 and income cash of$2,787.85. NOW, THEREFORE, it is proposed that the balance of the assets set forth in the First and Final Account be distributed as follows: To: To: To: To: To: PROPOSED SCHEDULE OF DISTRIBUTION Barbara H. Gaither, Niece One-half residue CASH $362,461.71 Jack L. Bair, Nephew One- fourth residue CASH $181,230.86 William H. Bair, Great-nephew One-twelfth residue CASH $ 60,410.29 Thomas R. Bair, Great-nephew One-twelfth residue CASH $ 60,410.29 Nancy Bair Graham, Great-niece One-twelfth residue CASH $ 60.410.29 $724.923.44 Total .,. COMMONWEAL TH OF PENNSYLVANIA ) ) ) SS: COUNTY OF CUMBERLAND LINDA J. LUNDBERG, Assistant Vice President of PNC Bank, N.A., Administrator of the Estate of Frances E. Simmons, being duly sworn according to law, deposes and says that the facts set forth in the foregoing Statement of Proposed Distribution are true and correct to the best of her knowledge, information and belief. PNC BANK, N.A. By. Linda J. Lundberg, Asst. ce President PNC Bank, N.A. (SEAL) NOTARIAL SEAL DENISE C. SULLENBERGER, Notary Public Hampden Twp., Cumberlsnd County My Commission Expires Nov. 22, 2004 B _~,~"__",""""",,,, ~8 459461 .\ C" PNCBANK ESTATE OF FRANCES E SIMMONS DECEASED (DIED 08/31/01) LATE OF THE BOROUGH OF CARLISLE CUMBERLAND COUNTY PA WILL NO 21-01-1054 INVENTORV COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND LINDA J LUNDBERG ASSISTANT VICE PRESIDENT OF PNC BANK, NATIONAL ASSOCIATION THE ADMINISTRATOR OF THE ESTATE OF FRANCES E SIMMONS DECEASED HAVING BEEN DULV AFFIRMED ACCORDING TO LAW DID DEPOSE AND SAY THAT THE ITEMS APPEARING IN THE FOLLOWING INVENTORV ARE PERSONAL ASSETS WHEREVER SITUATE AND REAL ESTATE IF ANY IN THE COMMONWEALTH OF PENNSVLVANIA OF SAID DECEDENT THAT THE VALUATION PLACED OPPOSITE EACH ITEM OF SAID INVENTORY REPRESENTS ITS FAIR VALUE AS OF THE DATE OF THE DECEDENT'S DEATH AND THAT THE DECEDENT OWNED NO REAL ESTATE OUTSIDE THE COMMONWEALTH OF PENNSYLVANIA EXCEPT THAT WHICH APPEARS IN A MEMORANDUM AT THE END OF THIS INVENTORY AFFIRMED AND SUBSCRIBED BEFORE ME THIS,/ ~ DAV OF ~ 20&- ~) ~~ C-- i):} ,.., 17Z 70. NOTARIAL SEAL DENISE C. SULLENBERGER Notary Public Hampden Twp.. Cumberland County My Commission Expires Nov. 22. 2004 - 1 - TRSNOll1019S. .' PRIVATE BANK PNCBANK FRANCES SIMMONS 770437 MISCELLANEOUS RINGS PNC BANK, NATIONAL ASSOCIATION TRUSTEE UNDER THE AGREEMENT OF TRUST OF FRANCES E SIMMONS DATED 8/7/86 ASSETS HELD AS OF 8/31/01 (DATE OF DEATH) IIl.tin 3,000 PAR USA SAVINGS BONDS SERIES HH DTD 05/01/1984 DUE 08/31/01 ill 100.0000 COMMON STOCKS 400 SHS BELLSOUTH CORP COMMON ill 37.7000 150 SHS FPL GROUP INC COMMON ill 54.7500 DIVIDEND PAYABLE 9/17/01 200 SHS QWEST COMMUNICATIONS COMMON a 21.1900 720 SHS SBC COMMUNICATIONS INC COMMON a 40.9300 506 SHS VERIZON COMMUNICATIONS INC COMMON a 49.9000 .E.Il.tDl1 2,953.119 UTS BLACKROCK FUNDS INDEX EQUITY PORTFOLIO FUND 45 INSTITUTIONAL CLASS a 21.8500 20,552.059 UTS BLACKROCK FUNDS INTER GOVERNMENT PORTFOLIO FUND 80 INSTITUTIONAL CLASS a 10.3900 INCOME TO 8/31/01 24,425.512 UTS BLACKROCK FUNDS MANAGED INCOME PORTFOLIO FUND 13 INSTITUTIONAL CLASS a 10.5500 INCOME TO 8/31/01 252.00 3,000.00 15,080.00 8,212.50 84.00 4,238.00 29,469.60 25,249.40 64,525.65 213,535.89 976.22 257,689.15 1,196.85 TRSNOlC101l15) - 2 - PRIVATE BANK FRANCES SIMMONS CONTINUED: FUNDS 27,462.308 UTS BLACKROCK FUNDS GNMA PORTFOLIO FUND 67 INSTITUTIONAL CLASS a 10.1800 INCOME TO 8/31/01 ~ PRINCIPAL CASH INCOME TO 8/31/01 ~ CAREFIRST BLUECROSS BLUESHIELD INSURANCE BENEFITS CASH FOUND IN ROOM PNC BANK NATIONAL ASSOCIATION CHECKING ACCOUNT 15140104218 DATE OF DEATH BALANCE 36,600.89 INTEREST TO 8/31/01 10.58 UNITED CHURCH OF CHRIST HOMES BALANCE IN PERSONAL RESIDENT TRUST FUND AARP REFUND DUE TO CANCELLATION OF MEMBERSHIP ADP COBRA SERVICES REFUND ON UNUSED PREMIUM PENNA DEPARTMENT OF REVENUE REFUND 2001 INDIVIDUAL INCOME TAX TOTAL INVENTORY - 3 - PNCBANK 279,566.30 1,400.58 16,266.13 54.29 770437 920,544.56 8.58 9.00 36,611.47 249.72 30.00 4,124.76 225.00 962,055.09 ------------ ------------ TASN02 00195) , PNCBAN~ ESTATE OF FRANCES E SIMMONS DECEASED (DIED 08/31/01) LATE OF THE BOROUGH OF CARLISLE CUMBERLAND COUNTY PA WILL NO 21-01-1054 INVENTORY COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND LINDA J LUNDBERG ASSISTANT VICE PRESIDENT OF PNC BANK, NATIONAL ASSOCIATION THE ADMINISTRATOR OF THE ESTATE OF FRANCES E SIMMONS DECEASED HAVING BEEN DULY AFFIRMED ACCORDING TO LAW DID DEPOSE AND SAY THAT THE ITEMS APPEARING IN THE FOLLOWING INVENTORY ARE PERSONAL ASSETS WHEREVER SITUATE AND REAL ESTATE IF ANY IN THE COMMONWEALTH OF PENNSVLVANIA OF SAID DECEDENT THAT THE VALUATION PLACED OPPOSITE EACH ITEM OF SAID INVENTORY REPRESENTS ITS FAIR VALUE AS OF THE DATE OF THE DECEDENT'S DEATH AND THAT THE DECEDENT OWNED NO REAL ESTATE OUTSIDE THE COMMONWEALTH OF PENNSYLVANIA EXCEPT THAT WHICH APPEARS IN A MEMORANDUM AT THE END OF THIS INVENTORY AFFIRMED AND SUBSCRIBED BEFORE ME ". / - I . /~ .:_.. ..' ~ C_ 20.4?- I~~ L1~} - ",\. .. vZ A\;'t\ ZOo NOTARIAL SEAL . DENISE C. SULLENBERGER. Nota~ ~ubtic Hampden T\~Jp., CUl}lberland SOI.In!)' My CommisSIon Expires Nov. 2z, ~.():I'l.A ~~'''''_'9''''~.:,'~~~~~~~~- - - 1 - TRSNOl1101951 ,. PRIVATE BANK PNCBANK FRANCES SIMMONS 770437 MISCELLANEOUS RINGS PNC BANK, NATIONAL ASSOCIATION TRUSTEE UNDER THE AGREEMENT OF TRUST OF FRANCES E SIMMONS DATED 8/7/86 ASSETS HELD AS OF 8/31/01 (DATE OF DEATH) ID.t:In 3,000 PAR USA SAVINGS BONDS SERIES HH DTD 05/01/1984 DUE 08/31/01 a 100.0000 COMMON STOCKS 400 SHS BELLSOUTH CORP COMMON a 37.7000 150 SHS FPL GROUP INC COMMON a 54.7500 DIVIDEND PAYABLE 9/17/01 200 SHS QWEST COMMUNICATIONS COMMON a 21.1900 720 SHS SBC COMMUNICATIONS INC COMMON a 40.9300 506 SHS VERIZON COMMUNICATIONS INC COMMON a 49.9000 ~ 2,953.119 UTS BLACKROCK FUNDS INDEX EQUITY PORTFOLIO FUND 45 INSTITUTIONAL CLASS a 21.8500 20,552.059 UTS BLACKROCK FUNDS INTER GOVERNMENT PORTFOLIO FUND 80 INSTITUTIONAL CLASS a 10.3900 INCOME TO 8/31/01 24,425.512 UTS BLACKROCK FUNDS MANAGED INCOME PORTFOLIO FUND 13 INSTITUTIONAL CLASS a 10.5500 INCOME TO 8/31/01 252.00 3,000.00 15,080.00 8,212.50 84.00 4,238.00 29,469.60 25,249.40 64,525.65 213,535.89 976.22 257,689.15 1,196.85 TASN02 <<10195) - 2 - , PRIVATE BANK FRANCES SIMMONS CONTINUED: FUNDS 27,462.308 UTS BLACKROCK FUNDS GNMA PORTFOLIO FUND 67 INSTITUTIONAL CLASS a 10.1800 INCOME TO 8/31/01 ~ PRINCIPAL CASH INCOME TO 8/31/01 ~ CAREFIRST BLUECROSS BLUESHIELD INSURANCE BENEFITS CASH FOUND IN ROOM PNC BANK NATIONAL ASSOCIATION CHECKING ACCOUNT 15140104218 DATE OF DEATH BALANCE 36,600.89 INTEREST TO 8/31/01 10.58 UNITED CHURCH OF CHRIST HOMES BALANCE IN PERSONAL RESIDENT TRUST FUND AARP REFUND DUE TO CANCELLATION OF MEMBERSHIP ADP COBRA SERVICES REFUND ON UNUSED PREMIUM PENNA DEPARTMENT OF REVENUE REFUND 2001 INDIVIDUAL INCOME TAX TOTAL INVENTORV - 3 - PNCBANK 279,566.30 1,400.58 16,266.13 54.29 770437 920,544.56 8.58 9.00 36,611.47 249.72 30.00 4,124.76 225.00 962,055.09 ============ TASN02110/9SJ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT PNC BANK NA PO BOX 38 CAMP HILL, PA 17001-0308 -------- fold ESTATE INFORMATION: SSN: 198-36-2458 FILE NUMBER: 2101-1054 DECEDENT NAME: SIMMONS FRANCES E DA TE OF PAYMENT: OS/24/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 08/31/2001 NO. CD 001212 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $8,524.00 I I I I I I I I TOTAL AMOUNT PAID: $8,524.00 REMARKS: PNC BANK NA CHECK# 415767 SEAL INITIALS: VZ RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT PNC ADVISORS POBOX 308 CAMP HILL, PA 17011 -------- fold ESTATE INFORMATION: SSN: 198-36-2458 FILE NUMBER: 21-2001- 1054 DECEDENT NAME: SIMMONS FRANCES E DA TE OF PAYMENT: 11/27/2001 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 08/31/2001 NO. CD 000561 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $121,600.00 I I I I I I I I TOTAL AMOUNT PAID: $121,600.00 REMARKS: PNC ADVISORS CHECK#411710 SEAL INITIALS: SK RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS I/) -c:2 / - // \.- BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z8D6Dl HARRISBURG. PA 171Z8-D6Dl LINDA LUNDBERG PNC ADVISORS PO BOX 308 CAMP HILL COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER DATE ESTATE OF DATE OF DEATH FILE NUMBER [1;0 19 :08 COUNTY ACN '* REV-75' EX AFP (01-02) '03 08-18-2003 SIMMONS 08-31-2001 21 01-1054 CUMBERLAND 202 FRANCES E Allount Rellitted l.:._ PA 1 tllJU MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR FILES ~ itEV =736--EX--AFP--{oi:.-o2i-----..-N'ifiic'E-oF--JiETE-RMINATIoti-AirJi-AssEsSMENT------------------------ --- -- OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL CLOSING LETTER .. ESTATE OF SIMMONS FRANCES E FILE NO.21 01-1054 ACN 202 DATE 08-18-2003 ESTATE TAX DETERMINATION 1. Credit For State Death Taxes as Verified 28,169.00 2. Pennsylvania Inheritance Tax Assessed (Excluding Discount and/or Interest) 130,124.00 3. Inheritance Tax Assessed by Other states or Territories of the United states (Excluding Discount and/or Interest) .00 4. Total Inheritance Tax Assessed 130,124.00 5. Pennsylvania Estate Tax Due .00 6. Amount of Pennsylvania Estate Tax Previously Assessed Based on Federal Estate Tax Return .00 7. Additional Pennsylvania Estate Tax Due .00 TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 -IF PAID AFTER THIS DATE, SEE REVERSE SIDE (IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) / 7-c:2 /-1/ ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRIS8URG1 PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER \ ',' :eqUNTY ACN 08-12-2002 SIMMONS 08-31-2001 21 01-1054 CUMBERLAND 101 "0.2 1 ~._] LINDA LUNDBERG PNC ADVISORS PO BOX 308 CAMP HILL PA 17001 Cl *' REY-1547 EX AFP CUl-02) FRANCES E Allount Rellitted ) CHANGED (1) (2) (3) (4) (5) (6) (7) .00 920.545.00 .00 41.512.00 .00 .00 .00 (8) MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ i"fY-=is4j-ix--AFP--coi-:02i--NOTici--OF-"rNHiifiTANCi-TAi-APPRA-isiMENT~--AL:rOWAiici-OR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF SIMMONS FRANCES E FILE NO. 21 01-1054 ACN 101 DATE 08-12-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequestsj Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax If an assessment was issued previoUSly, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: lS. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of LIne 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due X CR DITS: NOTE: + INTEREST/PEN PAID (-) 6,400.00 .00 DATE 11-27-2001 05-24-2002 NUMBER CD000561 CD001212 (9) (10) 50,926.00 (19)= NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYll8nt. 962,057.00 51.898 00 910,159.00 .00 910,159.00 .00 .00 .00 136,524.00 136,524.00 136,524.00 .00 .00 .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) 972.00 (11) (12) (13) (14) .00 X 00 = .00 X 045= .00 X 12 = 910,159.00 X 15 = AMOUNT PAID 121,600.00 8,524.00 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE \/?-c;2I'-I'/ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN *' REV-US EX AFP C 01- 02> '1) IL DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 08-12-2002 SIMMONS 08-31-2001 21 01-1054 CUMBERLAND 201 FRANCES E '02 n :16 LINDA LUNDBERG PNC ADVISORS PO BOX 308 CAMP HILL Amount Remitted .- PA iJOOl MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this form with your tax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR FILES ~ REV=48Y-Ex--AFP--[Or:-o2j-----..-NoficE-oF--IiETERMIifATIoti-Aifli-AssESSMENT---------------------------- OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN .. ESTATE OF SIMMONS FRANCES E FILE NO.21 01-1054 ACN 201 DATE 08-12-2002 ESTATE TAX DETERMINATION 1. Credit For State Death Taxes as Verified 28,169.00 2. Pennsylvania Inheritance Tax Assessed (Excluding Discount and/or Interest) 130,124.00 3. Inheritance Tax Assessed by Other States or Territories of the United States (Excluding Discount and/or Interest) .00 4. Total Inheritance Tax Assessed 130,124.00 5. Pennsylvania Estate Tax Due .00 TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 -IF PAID AFTER THIS DATE, SEE REVERSE SIDE (IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.J STATUS REPORT UNDER RULE 6.12 ~ o~ Name of Decedent: Frances E. Simmons Date of Death: August 31. 2001 Will No. 2001-01054 Admin. No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes X No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: Yes X a. No Did the personal representative file a fmal account with the Court? b. representative's account is: The separate Orphans' Court No. (if any) for the personal c. parties in interest? Yes Did the personal representative state an account informally to the No X d. Copies of receipts, releases, joinders and informal accounts may be filed with the Clerk of the Orphans' urt :~. LiP/OS provals of formal or ay be attached to this STANLEY A. SMITH, ESQUIRE RHOADS & SINON, LLP One South Market Square Harrisburg, PA 17101 (717) 233-5731 Capacity:XX Counsel for personal representative 466595. L REV-1500 EX + (6-00) OFFICIAL USE ONLY COMMONWEALTH OF PENNSYLVANIA REV-1500 11 '2-1 J \ .- - DEPARTMENT OF REVENUE DEPT. 280601 INHERITANCE TAX RETURN FILE NUMBER HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 21 2001 1054 COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER SJ:lIIMJNS , FRANCFS E. 198-36-2458 DECE- DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE DENT 08/31/01 11/13/1907 WITH THE REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 3. Remainder Return CHECK ~' Original Return r Supplemental Return ~ (date Df death prior to 12-13-82) APPRO- 4. Limited Estate 4a. Future Interest Compromise 5. Federal Estate Tax Return Required (date 01 death aller 12-12-82) PRIATE 6. Decedent Died Testate 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach copy of Will) (Attach a copy of Trust) BLOCKS 9. Litigation Proceeds Received 10. Spousal Poverty Credit (date 01 death between 0 11. Election to tax under Sec. 9113(A) 12-31-91 and 1-1-95) (Attach Sch 0) .!tH~~<rtmijM.Q~.jgq~piitt:qQl"g...:"Q.QijFltmf<<ii'.]M.,ijR?RMAfjQi..~ijQ.pUi.:~:.P.JR~P.:.t&~.. NAME COMPLETE MAILING ADDRESS COR- LINDA LUNDBERG , ASST VICE PRES. P.O. rox 308 RE- FIRM NAME (If Applicable) 4242 CARLISLE PIKE SPON DENT PNe ADVISORS CAMP HILL, PA 17001-0308 TELEPHONE NUMBER 1-717-730-2265 OFFICIAL USE ONLY 1. Real Estate (Schedule A) (1) None 2. Stocks and Bonds (Schedule B) (2) 920,545.00 . 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) None =_. 4. Mortgages & Notes Receivable (Schedule D) (4) None 5. Cash, Bank Deposits & Miscellaneous Personal - Property (Schedule E) (5) 41,512.00 - - 6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested (6) None RECA- PITULA- 7. Inter-Vivos Transfers & Miscellaneous TION Non-Probate Property (Schedule G or L) (7) 0.00 8. Total Gross Assets (total Lines 1-7) (8) 962,057.00 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 50,926.00 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 972 . 00 11. Total Deductions (total Lines 9 & 10) (11 ) 51,898.00 12. Net Value of Estate (Line 8 minus Line 11) (12) 910,159.00 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax (13) None has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 910,159.00 SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x.a (15) - 0.00 16. Amount ot Line 14 taxable at lineal rate 0.00 X .0 45 (16) TAX - 0.00 COMPU- 17. Amount of Line 14 taxable at sibling rate 0.00 X .12 (17) TATION 18. Amount of Line 14 taxable at collateral rate 910,159.00 X .15 (18) 136,524.00 19. Tax Due (19) 136,524.00 20. 0 !~K.ij~ffl~ilf:MQij.jij~ij~U~~AJ1~S:WijP'QfAW:QveRPAYM~ktl . . . . . . . . . . . . . . . . . . . . . . '::i.}-%J*J~;iiaim(tAN$weaA@:qQ\;$.tl~$.PNe:A~~?AWQ:eePB~KM~tM?;"):>H o PA15001 Copyright 2000 Greatland/Nelco LP - Forms Sollware Only NTF 29755 Estate of: FRANCES E. SlM'JDNS S(MIlARY OF .ALI.JXATICNS 'IO BENEFICIARIES Taxable at collateral rate BARBARA H. GATIHER JACKL.B1UR WIILIAM H. BAIR ~ R. B1UR NANCY BAIR GRAHAM 455,080.00 227,540.00 75,846.00 75,846.00 75,847.00 910,159.00 21-2001-1054 PA REV-1500 EX (6-00) D d t' C I Page 2 ece en S ampl ete ress: STREET ADDRESS 'lliORNWAlD HCME 442 WAI1iIUI' OOI'IUVI ROAD CITY I STATE I ZIP CARLISLE PA 17013 Add Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 136,524.00 121,600.00 6,400.00 Total Credits (A + B + C) (2) 128,000.00 3. Interest/Penalty if applicable D. Interest E. Penalty (3) 0.00 (4) (5) 8,524.00 (SA) 0.00 (5B) 8,524.00 Total Interest/Penalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + SA. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ~ ~ :: ~::::~ :;e~~~~i:n:~ii~~::S~:~ .S~~~'.~S.~ ~~~ ~~~~~~ ~r~.n~~~r.r~~ .o.r.i~s. i~~~~~;. . . .' : :: :::: :: : :::: . . d. receive the promise for life of either payments, benefits or care? .............................. 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ................................................... B ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................ 0 ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on information of which preparer has any knowledge. llN~A ~F W:R1>.~N RESPONSIBLE FOR FILING RETURN DATE BY: . , Assistant Vice President ~l 0 L AD E See Schedule attached SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS ~~;~~i~~~~~~;t~~~;~~~)j~i~?;Wd~~~g~i~;rj~~~~t;:\illg.;~~;:;~;r:!~~~i~J~::;:~:~~;D~;J~~ni~~:m~;~;;;J;;~~J~t~;;~:~JdJ,~~~~;J~i,~~~><>< [72 P.S. ~ 9116 (a) (1.1) (i)]. For dates of death on or after January 1. 1995, the tax rate is imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~ 9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax retum are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value 01 transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent. an adoptive parent. or a stepparent of the child is 0% [72 P.S. ~9116(a)(1.2)]. The tax rate imposed on the net value of transfers to orlor the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72.P.S. ~ 9116(1.2) [72 P.S. %9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. ij 9116(a)(1.3)]. A sibling is defined. under Section 9102. as an individual who has at least one parent in common with the decedent, whether by blood or adoption. o PA15002 NTF 29756 Copyright 2000 GreatlandlNelco LP - Forms Software Only Estate of: FRANCE'S E. SJlIoM1iIS 21-2001-1054 The follCMing person(s) are signing the retum as representative(s) of the estate: me ADVISORS 4242 CARLISLE PIKE P.O. POX 308 CAMP HILL, PA 17001-0308 REV-1503 EX + (1':97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FRANCES E. SIJ.VlIIONS SCHEDULE B STOCKS & BONDS FILE NUMBER 21-2001-1054 All property Jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NO. DESCRIPTION VALUE AT DATE OF DEATH 1 3, 000 UNITED STATES SVG ED SERIES HH 3,000.00 2 150 SHS FPL GROOP mc @54 . 75 PER SHARE 8,213.00 DIV .56 EX DATE 8/29/01 PAYABLE ~ 9/17.01 84.00 3 400 BELI..SOO'ID CORP @ 37.70 PER SHARE 15,080.00 4 200 SHS ~T CQ\1.'vUNIC'ATION INI'L mc. @ 21.19 PER SHARE 4,238.00 5 720 SHS SBC CXM-1UNIC'ATIONS INC. @ 40.93 PER SHARE 29,470.00 6 506 SHS VERIZON CQ\1.'vUNIC'ATIONS @ 49.90 PER SHARE 25,249.00 7 2,953.119 SHS BlACKR.<X:X FUND lNDEX EX;UITY mST @ 21.85 PER SHARE 64,526.00 8 24,425 .512 SHS BlACKR.<X:X FOND MANAGED mSTL @ 10.55 PER SHARE 257,689.00 ACXRUED DIVIDEND TO DATE OF DE'A.'IH 1,197.00 9 20, 552 . 059 SHS BlACKR.<X:X FOND INI'ER GVr mST @ 10.39 PER SHARE 213,536.00 ACXRUED DIVIDEND TO DATE OF DE'A.'IH 976.00 10 27,462 .308 SHS BIACKR.<X:X FOND GNMA RX>L mSTL @ 10.18 PER SHARE 279,566.00 ACXRUED DIVIDEND TO DATE OF DE'ATH 1,401. 00 11 16, 266 . 13 SHS BIACKR.<X:X US TREASURY M:NEY MARKEI' INSTL @ 1.00 PER SHARE 16,266.00 ACXRUED DIVIDEND TO DATE OF DE'A.'IH 54.00 TOTAL (Also enter on line 2, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 920,545.00 7 CPA31 NTF 10905 Copyright Forms Software Only, 1997 Nelco, Inc. REV-15GB EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER FRANCES E. SIMMONS 21-2001-1054 Include proceeds of litigation & date proceeds were received by the estate. All prop. Jointly-owned with right of survIvorship must be dIsclosed on Sch. F. ITEM VALUE AT NO. DESCRIPTION DATE OF DEATH 1 PNe BANK CHECI<nl3 ACCOUNI' #5140104218 INTEREST BE'ARJ}l; AND SOLE NAME OPENED 01/1972 ACCRUED INTEREST 'ill DATE OF DE'A'IH 2 CAREFIRST BLUECROSS BIlJESHIELD INSURANCE BEEFITS PAYABLE 6/2/01 3 CASH FOUND IN R<XM 4 UNITED CHURCH OF CHRIST HQVIE'S BAI.ANCE IN PERSCNAL RESIDEN!' TRUST FUND 5 REFUND FRCM AARP 6 ADP COBRA SERVICES FREFUND CN UNUSED PREMIUM A/e #B1312688 7 PERSCNAL PROPERTY PER APPRAISAL BY ROSE MARIE'S ANI'IQJES 8 REFUND FRCM PA nEPI' OF REVENUE FOR 2001 INDIVIDUAL INCQ\1E TI\XES 36,601. 00 11.00 9.00 9.00 250.00 30.00 4,125.00 252.00 225.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 41,512.00 7 CPA81 NTF 10908 Copyright Forms Software Only, 1997 Nelco, Inc. REV-1511 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FRANCES E. S~S SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-2001-1054 Debts of decedent must be reported on Schedule I. ITEM NO. DESCRIPTION A. FUNERAL EXPENSES: AMOUNT 1 MUSSELMAN FUNERAL HCME 4,487.00 2 PROSFECI' HIIJ.. CEMEI'ERy FEE FOR GRAVEMAKER AND INSCRIPITCN 585.00 3 RElMBURSE JACK PAIR FOR GRAVE OPENING AND SERVICE 730.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) PNC ADVISORS Social Security Number(s)/EIN No. of Personal Representative(s) Street Address 4242 CARLISLE PIKE, P.O. rox 308 City CAMP HILL State PA Zip 17011 25,641. 00 Year(s) Commission Paid: 2002-2003 2. 3. Attorney Fees NaIre: RHOADS & S:r::NJN LLP. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 18,000.00 0.00 4. Probate Fees 525.00 5. Accountant's Fees 0.00 6. Tax Return Preparer's Fees 0.00 See Schedule attached Total fran continuation page (8) 958.00 TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 50,926.00 7 CPA11 NTF 10911 Copyright Forms Software Only, 1997 Nelco, Inc. Estate of: FRANCE'S E. Sllv'M:NS SaiEDOLE H, PARI' B -- Administrative Costs Item No. Description 7 ROSE MARIE I S ANIT~ APPRAISAL OF BRASS BAND AND DIAMJND Rnl3 8 PNe BANK C'CMPENSATIeN IXJE eN 'mUST Acc..uJNI' 27-27-001-3132909 9 RHOADS & Sm:N REIMBURSEMENI' FOR LEnAL ADVERI'ISIOO 10 REGISTER OF WILlS - RESERVE FOR FILIOO ADVERTISING FIRST AND FINAL Acc..uJNI' 11 ADDmC'NAL AIMINISTRATIVE EXPENSES TOTAL. (Carry forward to main schedule) . . . . . . Page 2 21-2001-1054 Arrount 20.00 222.00 216.00 300.00 200.00 958.00 REV-1512 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FRANCES E. S:r:m::NS Include unreimbursed medical expenses. ITEM NO. SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 21-2001-1054 DESCRIPTION AMOUNT 1 PHARMERICA PRESCRIPI'ICN BALANCE DUE Aje 5702-01-02172 218.00 2 PA DBPI' OF REVONUE CUARIERLY INDIVII:XlAL S'rn..'IE ESTIMATED 'mX PAYMENT 310.00 3 me BANK PRINCIPAL a::MPENSATICN DUE AS OF 8/31/01 444.00 7 CPA12 NTF10912 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed. insert additional sheets of the same size) 972.00 Copyright Forms Software Only, 1997 Nelco, Inc. REV-1513 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER No. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 21-2001-1054 RELATIONSHIP TO DECEDENT AMOUNT OR Do Not Ust Trustee(s) SHARE OF ESTATE FRANCFS B. SIMVJ:NS 1 BARBA.RA H. GAI'IHER 954 FEL'Irn ROAD RED LION, PA 17356-9311 NIECE 455,080.00 2 JACK L. BArR 2535 CLDVERFIELD lANE EN:>IA, PA 17025 NEPHEW 227,540.00 3 WIlJ.,IAM H. BlUR 3977 BROO:KRIIX3E DRIVE MBCHANICSBURG, PA 17050 ~T NEPHEW 75,846.00 4 'IHCMAS R. BArR 64 BARBA.RA lANE HARRISBURG, PA 17112 ~T NEPHEW 75,846.00 5 NANCY BlUR GRAHAM 1602 ATIORNBY COURT HERNOCN, VA 20170 ~T NIECE 75,847.00 ENTER DOLLAR AMTS. FOR DISTRIBS. SHOWN ABOVE ON LINES 15 THROUGH 17 AS APPROPRIATE ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE :None B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS None TOTAL OF PART 11-- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00 7 CPA13 NTF 10913 (If more space is needed. insert additional sheets of the same size) Copyright Forms Software Only. 1997 Nelco. Inc. 717 730 2254 . P.01~02 C\. \. +S'50~ MAY -J.U.~::=::MM- f . TREAS .8PO zi'" REINVo' .. MAY a2 ...t~+..... : C ~ P : 8518 '.Ht+-++i" : JAN-29-2002 09:45 ,:-.~: I"' ~'I~'JY .,. !l . . I" .~'-,~/ . .~.f' . i PNC Bi=lNK ?i' 198-36-Z458 ';." 1"MRS FRANCES H StMMONS . 209 GREEN LANE R CAMP .HILl PA .1 011 o __If' -_II III _____ ..-----....-....-..... ........-..-. ..1III_..____-.-~IIfY.'IIII-.-. ....... -:.!I_---... .==-==- " .~-=.~ ~...:.~*~ SEJUES HH .. . .. .. . . .. ........ ....~....,. .... ..... ". , , ......-. M1270906 H J.J,/,... 1~srJ <.' c? '/'.~ ;,p;; " ,. . .1> -~- '. HI ':.'~ -:.'.~~..7...~ ....~. . :,.~.". .~.~.~I~lW'\~~~~,:::r'~,..~! h~..~9~"'.~.P.:-.~~,~:.~~.:t~::-:~~~t~~':.~~ .". ...' .. . .......:, ......... _._.l~...-....:....J..._.... ..;.1f.........,...-....~_...~.........,_.--.._...~.'-l...j....._-a. ~D1.l(g)_..~ A'.... _~_...._ aB~.~ Ji, 198-36-2458 MAS FRANCES H SIMMONS ;".~ 209 GREEN LANE DR .. . CAMP HIll PA 17011 __III 0 -_......1 ___.. "I ___ -.- ...._...._.... ........._ '1M........ ..--.----ilf..'IIII-.-....... -::=:=.: . ~=-.::.:=- .-";;0..- ~~..~ S~pIES DB I.SUE DATE IIlOCII 'S t1C ""' DA' ~ MAV -.W~::=::.'\UIoi- {; TREAS .8PD 23'" . REINV: " MAY 22'~98. "" c : p ; 8518 ',HH-fe-et" : , . .......... M1270907 Hi- ;jrli , . I' ---;;1-:r. ,.~ '. .: ~':.' ._~':"'....__ ." ....~.., o. .'0 ...-' ~;:=~_O .. ~. . ..,. r ........... . .... .' . on_ ... ;.; ....,..~;__ ~ 1R~ UBlIla___MDIB\ A'.... IIA~......-&.M' _8~ 1iI 198-36-2458 MRS FRANCES H SIMMONS '~,,,i 209 GREEN LANE DR ' ~. CAMP HILL PA 17011 o ..........,... ....__NiW-~........... ..---.-.."'-....-....---,-- ..m-III-----WI' 1IfY..__............. Mat::::.-=:.. ~ ,=.::-.:.:=-a , .::r.., >. A._ --.... r- --- ......;,.';Z:, _. __... M........_.__.______ ~__ ~-' - 1 m SERlES HH I M~-" y.- .J!!f!I\W'u~ '- To CoJOept Phone 1# Fax .. I.SUE DATE WMlOI'S 'III III1S' DAY O' MAY ..al!~ ::::,-i.u..-,- ~ . . .. TREAS .8po 23". - REtNV " MA y 22 I~""'" C : P 8518 ..!'tH-....-fW . " ...-...... M1270 908 HH ~ -v--.-. .........-........ .._.....k NDV-15-2001 15:57 PNC BRNK 717 730 2254 P.07/08 .... Erica L Schlegel .. :iWs'lP . . .. 09110/01 02:21 PM ... To: Judith M HaftUPNCAdvisorslSCP/PNC@PNC cc: Subject Date of Death Balances Estate of,Frances E Simmons Deceased SSN# 198-36-2458 000#08-31-2001 ACCOUNT NUMBER .DATE OF DEATH BALANCE + ACCRUED INTEREST. ESTABLISHED DATE DDA #5140104218 $36,600.89 + $10.58 01-01-1972 Have a great day!!! : ~) JAN-29-2002 09:45 PNC BANK ~~rtll"tll~ ~M' 1nade~ ~Med Jewelry, Estate Uquklatlonl, App,...... 2136 M8rket Street . CAMP Hlu., PENNSYLVANIA 17011 (717) 763-8198 10 WHOM IT MAY CONCEJlN: This is to certify that we 818 engaged in the business of appraising. buying and selling antiques. jewelry. silver and entire estates. We herewith certify that we have this day carefully examined the following listed and described articles. the properly of: NAME ~"[..b. a.:Y~ ,"i,~~~. ADDRESS We estimate the value as listed for insurance or other purposes at the current retail value. excluding Federal and other taxes. In making this Appraisal. we DO NOT agree to purchase or replace the articles. APPRAISED VALUE DESCRIPTION ./fK~~~Y/~~.~ IIJ. ~,' $t.~ .~I"~:Ik"~ .~.~....'.......<" ~.~..... 4/.:..d. J M~ ~~'~,..... . ~.~~-~~ f ~.()~ t5?,DO The foregoing Appraisal is made with the understanding that the Appraiser assumes no liability wilh respec;;tto any action that may be taken on the basis of this Appraisal. *-, ?Jt:uv~ . I>.J,d-ool APPRAISER DATE TOTAl P. 02 ~ rcro~1 FUNDED REVOCABLE TRUST AGREEMENT THIS AGREEMENT OF TRUST. executed in duplicate this ~ day of Or . 19~ between PRANCES IE. S I mmON.s. (hereinafter called Settlor). and CCNB BANK. N.A.. of New Cumberland. Cumberland County, Pennsylvania, (hereinafter called Trustee). WITNESSETH FIRST: Settlor grants. assigns and sets over to Trustee and its successors, all the property described in Schedule A. annexed hereto and said property. together with all other property, real or personal. that may be added to the Trust (such property and additions being hereinafter called principal), shall be held by Trustee, IN TRUST, upon the following terms. SECOND: Trustee shall manage all property comprising the principal of this Trust and shall collect the income therefrom and accretions thereto and shsll pay the net income and hold and distribute the principal of said Trust as follows: (A) Trustee shall pay the net income therefrom to Settlor for and during his or her lifetime, subject to the provisions of Item FIFTH, in such periodic installments as Trustee shall find convenient but at lease as often as quarter-annually. (B) Upon the death of Settlor, Trustee shall distribute the then remaining principal and any accumulated or undistributed income to Settlor's executor or administrator for distribution as a part of his or her estate. THIRD: The principal and income of this Trust shall be free from anticipation, assignment, pledge or obligation of Settlor and shall not be subject to any execution or attachment or to voluntary alienation. FOURTH: Trustee shall have the following powers in addition to those vested in it by law and by other provisions of this Trust, applicable to all property, whether principal or income, exercisable without court approval, and effective until actual distribution of all property: Page One of Four ~ (A) To retain any or all of the assets of this Trust,. real or personal, including stock of Trustee, or of its parent holding company, without regard .to any principal of diversification or risk. (B) To invest in all forms of property, including stock, common trust funds and mortgage investment funds whether operated by Trustee, or its parent holding company, without restriction to investments authorized for Pennsylvania Fiduciaries. as it deems proper. without regard to any principal of diversification or risk. (C) To sell at public or private sale. to exchange or to lease for any period of time, any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms or conditions as it deems proper. (D) To allocate receipts and expenses to principal or income or partly to each as Trustee from time to time thinks proper in its sole discretion. (E) To hold property in the name of Settlor or in ita name without designation of any fiduciary capacity. or in the name of a nominee or unregistered. FIFTH: Trustee may apply the net income of this Trust for the support of Settlor should he or she by reason of age, illness or any other cause. in the opinion of the Trustee, be incapable of disbursing it; and Trustee is further authorized to extend or apply from the principal of this Trust such sums as it, in its sole discretion. may. from time to time think advisable for the support of Settlor to maintain him or her in the station of life to which he or she is accustomed at the creation of this Trust. or during illness or emergency. SIXTH: Subject to the approval of Trustee. anyone may add property, real or personal. to the principal of this Trust by deed. will or otherwise. SEVENTH: Trustee shall receive compensation for the performance of its functions hereunder in accordanc~ with its standard scnedule of fees in effect from time to time during the period over which its services are performed. Page Two of Four EIGHTH: Settlor reserves to himself or herself the right by an instrument in writing intended to take effect during Settlor's lifetime signed by Settlor and delivered to Trustee to revoke or amend this Agreement in whole or in psrt provided that the duties, powers and liabilities of Trustee shall not be substantially changed without its written consent. NINTH: The situs of this Trust for administration and accounting pruposes shall be in the County of Cumberland and Commonwealth of Pennsylvania. and all questions pertaining to the construction or validity of the provisions of thia instrument shall be governed by the laws of that Commonwealth. IN WITNESS WHEREOF, Settlor has hereunto set his hand the day and year first above written and Trustee has executed this instrument and caused its corporate seal to be affixed hereto. i.. ;b;~t~.&(//-{) ~ ~ /~'J1/~ ~'f?' CCNB BANK, N .A. ATTEST: By ~A~ I f ~1u...'l.n..d By ff. (SEAL) Page Three of Four COMMONWEALTH OF PENNSYLVANIA ) S5: COUNTY OF CUMBERLAND ) On this. the 7m day of tZTJ . l~. before me a Notary Public. the undersigned officer, personally appeared J::rl.4N::6$? 13. 9fYJ(JJOAJ..> . known to me (or sstisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that s/he executed the same for the purpose therein contained. .881. DIANNA L 'A'N(.Il~' Pt~811C CAI' HIll IORG. cUlm u.n' ,:oum I' ca..IUIOR OPlm ~,!'T. 15.1'" ...IlIf. PtllllJl1llllllluociatiuq 01 1I0l1ri11 COMMONWEALTH OF PENNSYLVANIA ) S5: COUNTY OF CUMBERLAND ) On this. the...1!1L day of ~ me a Notary Public, the undersigned officer, personally appeared , 19~ before J . /I, >mIlEY , who. acknowledged himself to be the iI~~ Vile f't~/bt;Vr <J-.rtW:;r O~/ca . of CCNB BANK, N .A., a corporation. and that he as such 11,<; 'f VI('~ f{!.S:JI~ rt- r1!()j;, oFlicB!, being authorized to do so. executed the foregoing instrument for the purposes therein contained by signing the name of the corporation by himself as Ass't IIJf..t2 f'~~I()~W- d'"'1J"...t/~ "ffl'~..c IN WINTES5 WHEREOF. I ha seal. DI "~ l. PAYllf, TAR' PUllIe C~M HILL 80~li, CUM8fRWlD COUIITY MY COMMISSION EXPIRES Sf!'!'. 15. 1911 UIlIlbtr, ',nnsyllllnll A"oc.~lial\ of IIa11tllS Page Four of Four CCNB flANM N A CCNfB: MAIN OFFICE 331 BRIDGE STREET NEW CUMBERLAND. PENNSYLVANIA 17070 BANK F17) 774.7000 DIRECT (717) 780-2905 On this Trust Office, 2101 Market Street, Camp Hill, Pennsylvania 17011 RECEIPT FOR ASSETS FUNDED REVOCABLE TRUST AGREEMENT 7TH AUGus.T , 19 8" ,we acknowledge day of receipt of the following assets in order to fund the Revocable Living Trust for F~ANCES E. SimmONS I' SHARES . 21#0 S~ARES 20 SHII~E S Z SHARE5 I (, $HIl~es 1.3{3.'lltNI'TS . (}. ~7 T ~ SH~5 7~ S1IA~t:<, 17 5fWIEs /(, SHI/IlES. 33 SHIItES \ 13 SHiItes ( IJ 10. '2.00 NUVEfSN rAX-cX6/11f'r BoNI> FU~b OPPS/IJHfilfl'l6~ HI&II YIELtJ FUNb. lAiC.. P. P. ..rL. Co., Ctu.,MoAJ P. p. 'H., Co. "I-t c>/~ PFb + (17 slfltleEs. ON iTH"tl'oMl(y c~nFi4TE) PtJl3L1c. SEKv/cE ElECne/C 01- GAS c~, UN/TEb erA ~ Imf'j(()VE~EAlr co, (UGIJ YO!<K WA~ Co VIII/TEl::> CJ..ItJ'€cJ./ of CHRlsr /-10,-1165. 5.0"/0 bEO. Acknowledged By: ~~ E: ~~ ( ignature of Settlor) CCNB BANK, N. A. By:B:.a. ~ . A. Smiley Trust Officer (Signature of Settlor) "SCHEDULE A" P~. 1 .f 2. ./ CCNB CCNO f~ANM. NA MAIN OFFICE 331 BRIDGE STREET NEW CUMBERLAND. PENNSYLVANIA 17070 BANK 1717) 774.7000 DIRECT (717) 780-2905 Trust Office, 2101 Market Street, Camp Hill, Pennsylvania 17011 RECEIPT FOR ASSETS FUNDED REVOCABLE TRUST AGREEMENT On this 7 '11-1 day of AUGUST , 19~, we acknowledge receipt of the following assets in order to fund the Revocable Living Trust for FRANces E SIfY1fY1oNS U. oS. SAV/lu65 80Nf>.s. SE;~/E5, HH l 4000. 00 J /' DAvPJ./II\l" bCl'oSIT C/O.;:; 0'15575. bVE 7/13/88 /9.730.." ....l-IfttUI5 SAVIN&'S Assoc. c/o:lt S-/6-03Cf~II, bilE ~/'I/~8 ";l/87.71 .... At<5T FE'bE:~AL SAVIN&; .....(,(J/tN clt># 2 .Z.I.{-o7 '2./2.2. DIIE' to/nIt' 4.5/3.2.3 CCtlJ(3' 8M/} N.A. elf:) #' fj2701 . bilE 7/2&/90 ,-.07>.00 ofP6fliHel/'l7EI!.. mONEy />1A~/<E-r FflJJb] INC. s:. ,g0.339i/htES Acknowledged By: ~ i%~/t. ~~~ ( Signature of Settlor) CCNB BANK, N. A. B (Signature of Settlor) "SCHEDULE A" ~ 2. .F 2